By Dr David Laing Dawson
In 1971, before my own son was born, a seventeen year old boy left his family home in Ontario, and traveled to the southern United States with his guitar and little else. This young man, Derek, dressed in a robe and sought out an audience for his message of peace and love. He was hospitalized there, his parents contacted, and they drove down to bring him home. Back in Ontario they brought him to the new Community Psychiatry Program at the Medical Center. This was the Thursday before the Easter Holiday weekend. The young man, fully alert and full of energy, was convinced that he had been appointed by God to deliver these messages. But he didn’t want my medication, and he did not want to be admitted to hospital. His parents agreed to take him home and bring him back for a second visit the following week.
This family went to church on Easter Sunday, and to everybody’s dismay, the young man jumped to his feet, interrupted the Priest, and began a loud, rambling sermon of his own. An ambulance was called and he was taken to hospital. His response to medication was good, and when well, he proved to be a bright, engaging, sensitive, smart young man, capable of succeeding in College and life. But he did not like taking the medication. He preferred, quite understandably, the sensation of invulnerability, of energy, of warmth and possibility, of certainty, that accompanies a state of hypomania and delusions of grandeur. He remained my patient for five years, and I struggled with him to find a pharmacology that would keep him sane without taking away his enthusiasm. He often stopped the pills, became ill, and then reluctantly agreed to try again.
After five years I moved to head a different clinic in another part of town, and then out of town, and then five years later, back to town. I had lost track of Derek, and now my own son was that age, seventeen, and I was driving him to something. I think it was October and the leaves were changing on Aberdeen, a wide road of old and stately houses, some of which had been converted to group homes. We slowed at a busy corner, and on that corner a bearded man with unruly hair and disheveled clothing stood, paced, gesticulated and shouted at imagined specters or people in the street, in the clouds, and in the trees. It was unmistakably Derek, now in his mid 30’s.
“Shit.” I said.
“What’s wrong?” asked my son.
“That man,” I explained. “He was my patient years ago, when he was your age.”
He looked at the psychotic man raving at invisible targets. “Dad,” he said, “It’s not your fault.”
But really, we did fail Derek, didn’t we?